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病例19-2018:一名患急性肾损伤的15岁女童
Case 19-2018 — A 15-Year-Old Girl with Acute Kidney Injury


Ann Y. Kao ... 围产医学和儿科 其他 • 2018.06.21

病历陈述


Helen I. Healy医师(儿科):一名15岁女童在夏季因急性肾损伤入住本院。

入院前8日,患者出现下腹部绞痛和出血性腹泻,此前患者状态良好。大约每小时排便1次,患者无法入睡。患者服用了布洛芬,但腹痛没有缓解。

在患病第3日,患者发生了两次非血性非胆汁性呕吐。次日,患者到她的初级保健儿科医师处就诊。患者报告感到疲倦,并且腹泻、腹部绞痛和呕吐持续存在;患者未发热。体格检查结果正常。采集粪便样本,进行沙门菌、志贺菌、弯曲杆菌、气单胞菌、邻单胞菌和大肠杆菌O157:H7培养,并进行轮状病毒、贾第虫和艰难梭状芽胞杆菌毒素抗原检测。建议患者停止服用布洛芬,根据需要服用洛哌丁胺和对乙酰氨基酚,并饮用含电解质的口服补液溶液。在接下来的3日内,腹泻消失,但患者每日继续呕吐数次,腹部绞痛局限于上腹部。粪便培养和抗原检测结果为阴性。在患病第7日,患者母亲打电话给儿科医师诊室,医师开出昂丹司琼处方。





作者信息

Ann Y. Kao, M.D., M.P.H., Pallavi Sagar, M.D., Jean E. Klig, M.D., Amita Sharma, M.D., and Kristen J. Tomaszewski, M.D.
From the Departments of Pediatrics (A.Y.K., A.S.), Medicine (A.Y.K.), Radiology (P.S.), Emergency Medicine (J.E.K.), and Pathology (K.J.T.), Massachusetts General Hospital, and the Departments of Pediatrics (A.Y.K., A.S.), Medicine (A.Y.K.), Radiology (P.S.), Emergency Medicine (J.E.K.), and Pathology (K.J.T.), Harvard Medical School — both in Boston.

 

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